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Dynamic CT findings of cholangiolocellular carcinoma: correlation with angiography-assisted CT and histopathology

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Abstract

Objectives

To elucidate the dynamic CT features of pure type of cholangiolocellular carcinoma (pure CoCC) in comparison with those of cholangiocellular carcinoma (CCC) and to analyze their bases by angiography-assisted CT with histopathologic correlation.

Methods

Surgically confirmed 10 pure CoCCs, 10 CCCs and 7 mixed CoCC and CCCs from August 2001 to May 2012 were included in this study. Among them, dynamic CT features were compared. In 8 pure CoCCs, the correlative study between angiography-assisted CT and histopathological study was performed to clarify the basic mechanism of dynamic CT features.

Results

All pure CoCCs showed early and prolonged enhancement homogeneously or inhomogeneously and 8 of 10 pure CoCCs showed early peritumoral enhancement on dynamic CT. Time-attenuation curve provided by dynamic CT showed significant higher Hounsfield unit value of pure CoCC than those of CCC at each phases (p < 0.05). The depiction of peritumoral enhancement in CoCC was nearly simultaneous to tumor stain on dynamic CT during hepatic arteriography. Pathologic analysis revealed there were abundant communications between blood sinusoids of the tumor and intra and peritumoral portal venules and surrounding hepatic sinusoids.

Conclusion

Early tumoral staining and peritumoral enhancement due to early drainage from the tumor and prolonged enhancement are characteristic findings in pure CoCCs.

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Abbreviations

CoCC:

Cholangiolocellular carcinoma

CCC:

Cholangiocellular carcinoma

CTHA:

CT during hepatic arteriography

CTAP:

CT during arterial portography

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Acknowledgments

We are indebted to Kunikazu Saikawa, CT, Nobuyuki Matsushita, CT, and Hiroko Ikeda, CT for their technical support in preparation of the histologic sections. We thank John Gelblum for the assistance in preparing the manuscript.

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Correspondence to Kazuto Kozaka.

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Funding

This study has received funding by a Grant-in-Aid for Science Research [24791283] from the Ministry of Education, Culture, Sports, Science and Technology.

Conflict of Interest

All authors declare that they have no conflict of interest.

Ethical approval

Our institutional review board approved this retrospective study and waived the requirement for informed consent.

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Kozaka, K., Matsui, O., Kobayashi, S. et al. Dynamic CT findings of cholangiolocellular carcinoma: correlation with angiography-assisted CT and histopathology. Abdom Radiol 42, 861–869 (2017). https://doi.org/10.1007/s00261-016-0944-z

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